Dr. Hope on Treatment Options for GEP-NETs

Thomas Hope, MD, an associate professor of radiology at University of California, San Francisco, discusses treatment options for patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

Treatment strategies for patients with GEP-NETs are typically split into 2 categories: small bowel NETs and pancreatic NETs. The treatment methodology for patients is based on the primary origin of the tumor.

Patients with small bowel NETs will typically receive treatment with somatostatin analogs. After progression, patients may consider peptide receptor radionuclide therapy (PRRT) or everolimus (Afinitor), depending on the pace and extent of disease.

Pancreatic NETs have a higher Ki-67 score and patients may, depending on the aggressiveness and extent of tumor presentation, start with capecitabine (Xeloda) plus temozolomide or a somatostatin analog. Other approved therapies to treat patients with pancreatic NETs include sunitinib (Sutent), everolimus, or PRRT.

The sequencing of treatments for both diseases is unclear. Other treatment options include surgery and liver-directed therapy. However, with multiple options and an unclear sequencing strategy, the choice is complex, concludes Hope.